Nederlands tijdschrift voor geneeskunde
-
Ned Tijdschr Geneeskd · Jan 2011
Case Reports[Camphor poisoning following ingestion of mothballs 'for headache'].
Camphor is a toxic hydrocarbon, found in numerous over-the-counter medicinal products and chemist-shop items. The consequences of camphor poisoning depend on the dose, and severe poisoning can result in death. Ingestion of camphor can cause seizures, apnoea, renal insufficiency, raised hepatic enzyme levels, and vomiting resulting in chemical pneumonitis due to aspiration. ⋯ Many every-day products contain camphor. Poisoning can lead to an acute clinical picture, and immediate intensive care department treatment is obligatory. As there is no antidote available, supportive care is the only available option when poisoning occurs.
-
A 57-year-old woman came to the dermatologist because of 'strange bumps' on her feet. The bumps were not painful. ⋯ They had the same colour as the skin and decreased in size while sitting. The diagnosis was: 'piezogenic papules'.
-
Primary torsion of the omentum majus is a rare condition. The clinical picture can mimic other causes of acute abdominal pain. The condition is therefore often not recognised and the diagnosis is made only perioperatively. ⋯ In any patient with episodes of recurrent, localised, stabbing abdominal pain, possibly related to exercise and without any other clear diagnosis, the diagnosis 'torsion of the omentum majus' should be considered.
-
Screening with low-dose computed tomography reduces lung cancer mortality. However, the high incidence of false positive screening results, the uncertainty of the duration of screening and the lack of a cost-effectiveness analysis should be overcome before introduction in a daily clinical practice.
-
Awake flexible intubation is the gold standard for difficult airway management but failures have been reported in up to 13% of cases. A novel technique called 'awake fibrecapnic intubation', developed in the Netherlands, is described here for the intubation of patients with head and neck cancer who have a difficult airway. After topical anaesthesia is administered, a flexible fibrescope is introduced into the pharynx. ⋯ Spontaneous respiration is maintained in all patients. When four capnograms have been obtained, the flexible scope is railroaded over the catheter and after identification of tracheal rings or carina, the tracheal tube is placed. This new intubation technique is easier to learn than awake flexible intubation.